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Acute renal failure in community-acquired bacteraemia
B L Rayner1, P A Willcox, M D Pascoe
1Renal Unit, Groote Schuur Hospital, South Africa.
Nephron
|January 1, 1990
Summary
Acute renal failure (ARF) affects 24% of patients with community-acquired bacteremia. ARF significantly increases mortality, especially when renal function does not improve after treating the infection.
Area of Science:
- Nephrology
- Infectious Diseases
- Critical Care Medicine
Background:
- Community-acquired bacteremia is a significant cause of morbidity and mortality.
- Acute renal failure (ARF) is a known complication of severe infections.
- The prevalence and impact of ARF in bacteremic patients require further elucidation.
Purpose of the Study:
- To determine the prevalence of acute renal failure (ARF) in patients with community-acquired bacteremia.
- To evaluate the outcomes and mortality associated with ARF in this patient population.
- To identify factors influencing ARF outcomes in bacteremic patients.
Main Methods:
- Prospective evaluation of 239 patients with community-acquired bacteremia over one year.
- ARF defined as a doubling or more in serum creatinine.
- Comparison of mortality rates between patients with and without ARF, and within ARF subgroups.
Main Results:
- ARF was identified in 58 patients (24%).
- Mortality was significantly higher in patients with ARF (53%) compared to those without (22%).
- Patients with persistent ARF had a much higher mortality rate (89%) than those with resolution (20%).
Conclusions:
- ARF is a common and serious complication of community-acquired bacteremia.
- Early resolution of renal failure is critical for improved survival.
- Persistent ARF in bacteremic patients carries a very poor prognosis, often preceding death from overwhelming sepsis.